Abstract

To the editor: Martin and associates (1) document the futility of waiting for myocardial infarction before instituting therapy. Increasing efforts over the past 30 years
have resulted in no change in the in-hospital mortality. We should turn some of our efforts toward prevention of coronary heart disease during the next 30 years.

Risk factors can be controlled and mortality reduced if the approach is vigorous enough. We advocate the lifestyle of the marathon runner, since immunity to coronary heart disease appears to coexist with the ability to cover 42 kilometres on foot (2). Kavanagh, Shephard, and Pandit (3) have shown